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Full text of "Rapid Population Growth Consequences And Policy Implications"

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Manpower:                   (1) doctors (2) nurses (3) midwives
Facilities:                     (4) hospital beds
Expenditures:               (5) total health (6) family planning
Table 3 lists the current level for the first five indices for each LDC listed in Table 1 for which information is available. Table 4 lists similar data for the same MDC's used in Table 2. Table 5 lists family planning expenditures for several national programs.
Health Manpower
Doctors. The range within the LDC's is great-from 2 to 3 per 100,000 population in tropical Africa, Afghanistan, Indonesia, and Nepal to 75 to 89 in the Philippines and Cuba. Most countries of Latin America are over 40, and the average for Asia is under 20. Most MDC's have over 100, the U.S.S.R. over 200. Most doctors in most countries are male, the U.S.S.R. being an important exception.
More important, perhaps, than national averages is that the conditions under which modern doctors perform effectively are those which characterize the MDC's, not the LDC's. Such conditions are present in the major urban areas of LDC's where doctor:population ratios do approximate national ratios for MDC's (17-19). Doctor population ratios in rural areas of LDC's are low almost everywhere.
Nurses. Again the LDC range is great—from 3 or less in Afghanistan, Nepal, and Ethiopia to 110 in Cuba and 160 in Chile; in comparison with more than 250 in most MDC's. There is a tendency for LDC's with low doctor ratios to have high nurse ratios (e.g., Indonesia, Nigeria, Thailand, Sudan, Tanzania, Kenya, Ghana) and vice versa (e.g., Brazil, Mexico, Turkey, U.A.R., Colombia, Taiwan), but too many exceptions occur for any useful relationship to emerge from these data alone.
Midwives. For trained midwives the range is great for both LDC's (from less than 1 to 40) and MDC's (less than 1 to 74). These figures do not take into account the large number (usually uncounted) of local, untrained mid-wives or the smaller number of nurse-midwives in many countries. (The latter are included in the nurse category in the tables but can be separated.)
Health Facilities
Hospital Beds. Except for Afghanistan and Nepal with under 20 per 100,000 population; Pakistan, Nigeria, Korea, and Ethiopia with under 50; and Cuba with over 500, most hospital bed population ratios for LDC's are in the range 80-300, whereas MDC ratios are around 1,000. Hospital beds require a certain amount of health manpower, such as doctors and nurses, tof the best single indices of national health available. Figure 3 shows the relationship between per capita gross national products and infant mortality rates in 1965.